The patient position and approach depends upon the exact location of the renal mass. The patient is placed in flank position with the affected side up. The primary surgeon, the first assistant, and the scrub nurse stand facing the abdomen (transperitoneal approach) or facing the spine (retroperitoneal approach). The second assistant (optional) will be on the opposite side. The monitor towers are stationed at the patient's shoulders and angled slightly toward the feet at an eye level comfortable to the operating personnel. The tower containing the laparoscopic insufflator, light source, and camera should be across the primary surgeon to facilitate monitoring of the pressure recordings. The harmonic and electrocautery generator units are at the patient's feet across from the primary surgeon. The suction irrigator/aspirator system is hung on the anesthetic pole on the side of the primary surgeon at the head of the table. The scrub nurse's Mayo stand is placed directly above the patient's legs and the remaining laparoscopic instruments are placed on another table in an L-shaped configuration for easy access (Fig. 1).
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